WO2020121519A1 - Applicateur, et instrument médical ainsi que procédé d'installation de celui-ci - Google Patents

Applicateur, et instrument médical ainsi que procédé d'installation de celui-ci Download PDF

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Publication number
WO2020121519A1
WO2020121519A1 PCT/JP2018/046121 JP2018046121W WO2020121519A1 WO 2020121519 A1 WO2020121519 A1 WO 2020121519A1 JP 2018046121 W JP2018046121 W JP 2018046121W WO 2020121519 A1 WO2020121519 A1 WO 2020121519A1
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WO
WIPO (PCT)
Prior art keywords
link
distance
unit
operating
sheath
Prior art date
Application number
PCT/JP2018/046121
Other languages
English (en)
Japanese (ja)
Inventor
泰之 藤本
健輔 上阪
Original Assignee
オリンパス株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by オリンパス株式会社 filed Critical オリンパス株式会社
Priority to CN201880100067.9A priority Critical patent/CN113164174A/zh
Priority to PCT/JP2018/046121 priority patent/WO2020121519A1/fr
Publication of WO2020121519A1 publication Critical patent/WO2020121519A1/fr
Priority to US17/344,072 priority patent/US20210298759A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A61B17/1222—Packages or dispensers therefor

Definitions

  • the present invention relates to an applicator for treating a target tissue in the body, a medical device (more specifically, a ligating device used for ligating a tissue), and a method for mounting the medical device.
  • the endoscope treatment tool described in Patent Document 1 includes a tubular outer sheath, a tubular inner sheath inserted through the outer sheath, a drive wire inserted through the inner sheath, and a distal end of the drive wire.
  • Connected to the base connected to the proximal end of the inner sheath, and the proximal end of the drive wire, and has a slider part slidable with respect to the base part.
  • the base portion has a fixed base having two positioning grooves formed therein and a rotating base having one positioning groove formed therein.
  • the clip opening position where the connecting hook is opened the clip fastening position where the clip held by the connecting hook is fastened, and the connecting hook is closed to remove the clip. It has three positions, a clip connecting position where the clip is gripped and the clip is not fastened.
  • the clip release position is the position where the slider is pulled out from the base part most
  • the clip fastening position is the position where the slider is pushed most into the base part
  • the clip connecting position is the clip release position and the clip fastening position. Is the position set between.
  • the connecting hook projects from the distal end of the inner sheath and opens due to its own elastic force. You can leg.
  • a medical device for treating (ligating) a target tissue in a body is a treatment instrument (for example, a clip) to be inserted into the body and a device for adjusting a position and a posture of a treatment section by an operator's hand. It is configured by connecting with an applicator.
  • a target tissue in the body is treated using such a medical device, for example, additional treatment may be performed on a new target tissue that could not be found in the preoperative examination.
  • a clip is used as a treatment tool, it is necessary to exchange a plurality of clips in order to ligate each of a plurality of target tissues.
  • a new treatment tool be attached to the applicator, that is, a so-called treatment tool can be reloaded.
  • the medical device can both reload the treatment portion and allow the treatment tool to re-grasp the target tissue.
  • the slider is moved from the clip connecting position to the distal end side with respect to the base portion in order to adjust the gripping state of the target tissue by the clip. Need to move. However, such movement may move the endoscopic treatment tool to the clip open position and release the connection state between the clip and the connection hook. That is, the treatment tool for an endoscope described in Patent Document 1 does not consider re-grasping of the target tissue by the treatment tool, and it is not possible to make the treatment tool reloadable and re-grasp the target tissue by the treatment tool. There are challenges.
  • the present invention has been made in view of such problems, and an applicator and a medical device (more specifically, a ligation device) that realizes both re-loading of a treatment tool and re-grasping of a target tissue by the treatment tool.
  • the purpose is to provide.
  • the other object of this invention is to provide the method of mounting
  • a medical device includes a clip unit having a first arm, a second arm, and a first link, and an applicator having an operation wire for operating the clip unit, The applicator is provided on the operation wire, and a second link that transitions between a release form in which the engagement with the first link is released and an engagement form in which the first link is engaged, and the operation wire. And a sheath capable of accommodating the second link, a first operation unit connected to the operation wire for moving the second link by advancing and retreating operation, and adjusting a distance from the first operation unit to the second link.
  • a second operation portion for performing a transition between the engagement form and the release form of the second link when the second link is positioned inside the sheath, the transition being restricted by the sheath.
  • the second operation unit is configured to move the first operation unit back and forth.
  • the different operation can change the distance from the first operation unit to the second link from the first distance to the second distance.
  • the first distance is defined as the distance from the first operating section to the second link when the first operating section is most advanced and the second link is protruding from the sheath.
  • the second distance is defined as the distance from the first operating unit to the second link in a state where the first operating unit is most advanced and the second link is located inside the sheath.
  • the first link and the second link are in the engagement form, and the first operation unit to the first operation unit.
  • the distance to the two links is the second distance
  • at least the connecting portion between the first link and the second link is inside the sheath when the first operating portion is at the most advanced position. May be located.
  • the clip unit has a tubular shape and has a holding tube into which the first arm and the second arm can be inserted.
  • the first link may be connected to the first arm and the second arm and may be arranged at a position projecting from the pressing tube.
  • the first link and the second link are in the engagement form, and the first operation portion to the second In a state where the distance to the link is the second distance, the pressing tube and the sheath may come into contact with each other when the first operation portion is at the most advanced position.
  • the applicator is configured to operate the second operating unit to operate the distance from the first operating unit to the second link. May further include a restriction unit that restricts the change.
  • the second operating portion has a length of the operating wire that connects the first operating portion and the second link.
  • the distance from the first operation unit to the second link may be changed from the first distance to the second distance by adjusting.
  • the second operating portion has a rotating member around which at least a part of the operating wire is wound, and the rotating member.
  • the operation wire may be wound around the rotating member by the rotating operation of.
  • the applicator restricts the rotating operation of the rotating member, so that the second operating portion moves from the first operating portion to the second operating portion. You may further provide the control part which controls that the said distance to a link changes.
  • the second operation section has a slide member movably engaged with the first operation section.
  • the operation wire may be fixed to the slide member of the second operation unit.
  • the slide member has a protrusion that engages with the first operating portion, and the protrusion is the slide member. A position that is locked to the first operation unit in a state where the distance from the first operation unit to the second link is changed to the second distance by moving with respect to the first operation unit. May be provided.
  • An applicator is an applicator that is connected to a clip unit having a first arm and a second arm, the applicator including an operation wire for operating the clip unit, and A link provided on the operation wire, which transitions between a released form in which the engagement with the clip unit is released and an engaged form in which the clip unit is engaged, and a sheath capable of accommodating the operation wire and the link, A first operation unit that is connected to the operation wire and that moves the link by an advancing/retreating operation; and a second operation unit that adjusts the distance from the first operation unit to the second link, wherein the link is the When located within the sheath, the transition of the link between the engaged and disengaged configurations is regulated by the sheath, and when the link projects from the sheath, the link is disengaged from the disengaged configuration.
  • the second operation section changes the distance from the first operation section to the link from the first distance by an operation different from the forward/backward movement of the first operation section.
  • the distance can be changed to a second distance
  • the first distance is defined as the distance from the first operating portion to the link in a state where the first operating portion is most advanced and the link projects from the sheath.
  • the second distance is defined as the distance from the first operating portion to the link in a state where the first operating portion is most advanced and the link is located inside the sheath.
  • the second operating portion has a length of the operating wire that connects the first operating portion and the link.
  • the distance from the first operation unit to the second link may be changed from the first distance to the second distance by adjusting.
  • the distance from the first operating section to the second link is changed by operating the second operating section. You may further provide the control part which controls that.
  • a mounting method is provided with a clip unit having a first arm, a second arm, and a first link, an operation wire for operating the clip unit, and the operation wire, A second link that transitions between a released form in which the engagement with the first link is released and an engaged form in which the first link is engaged; a sheath capable of accommodating the operation wire and the second link;
  • a medical device comprising: a first operation unit that is connected to an operation wire and that moves the second link by an advancing/retreating operation; and a second operation unit that adjusts a distance from the first operation unit to the second link.
  • a method for mounting a clip unit wherein the mounting method is from the first operating section to the second link in a state in which the first operating portion is most advanced and the second link projects from the sheath. Is defined as a first distance, the first operating portion is most advanced, and the second link is located in the sheath, the first operating portion to the second link The distance is defined as a second distance, and the distance from the first operation unit to the second link is set to the above-mentioned distance by operating the second operation unit with an operation different from the forward/backward movement of the first operation unit. Changing the second distance to the first distance, moving the first operating portion to the most advanced position, and operating the second operating portion by an operation different from the forward/backward movement of the first operating portion. By doing so, changing the distance from the first operation unit to the second link from the first distance to the second distance.
  • the second operation section is operated by an operation different from the advance/retreat operation of the first operation section, and the first operation section is operated.
  • the distance from the first operation unit to the second link is set to be the distance between the first distance and the second distance. You may change in between.
  • the mounting method according to the above fourteenth aspect after moving the first operating portion to the most advanced position, operating the second operating portion, the distance from the first operation unit to the second link may be changed from the second distance to the first distance, and the second link and the first link may be engaged with each other.
  • the second operating portion is operated, and the distance from the first operating portion to the second link is After changing from the second distance to the first distance, the first operating portion may be moved to the most advanced position to engage the second link and the first link.
  • the medical device and the applicator it is possible to realize both the reloading of the treatment tool and the re-grasping of the target tissue by the treatment tool. Further, according to each of the above aspects of the method of mounting the clip unit in the medical device, it is possible to preferably mount the clip unit in the medical device by engaging the clip unit with the applicator.
  • FIG. 1 It is a perspective view which shows typically the structure of the clip unit which concerns on the 1st Embodiment of this invention. It is a perspective view which shows typically the structure of the arm member in the clip unit which concerns on this embodiment. It is a fragmentary sectional view in side view of a clip unit concerning this embodiment. It is a fragmentary sectional view in plane view of a clip unit concerning this embodiment. It is a fragmentary sectional view in plan view of a treatment implement body concerning this embodiment. It is a fragmentary sectional view in side view of a treatment implement main part concerning this embodiment. It is a perspective view which shows typically the structure of the clip case which concerns on this embodiment. It is a perspective view showing the mode in which the clip unit concerning this embodiment is stored in a clip case.
  • FIG. 1 It is a top view which shows the structure of the lower case of the clip case which concerns on this embodiment. It is a fragmentary sectional view in side view of a clip case concerning this embodiment. It is a figure which shows operation which attaches a clip unit to the treatment tool main body which concerns on this embodiment. It is a figure which shows operation which attaches a clip unit to the treatment tool main body which concerns on this embodiment. It is a figure which shows operation which attaches a clip unit to the treatment tool main body which concerns on this embodiment. It is a figure which shows operation which attaches a clip unit to the treatment tool main body which concerns on this embodiment. It is a figure which shows operation which attaches a clip unit to the treatment tool main body which concerns on this embodiment. It is a figure which shows operation which attaches a clip unit to the treatment tool main body which concerns on this embodiment.
  • FIG. 13C is a radial cross-sectional view of the applicator as seen from the proximal end side of the medical device along XIIC-XIIC in FIG. 12B. It is a perspective view which shows typically the structure of a part of operation part of the medical device which concerns on this embodiment. It is a figure which shows operation which treats a target tissue using the medical device which concerns on this embodiment.
  • the medical device 1 according to the present embodiment is used by being inserted into a patient's body through a channel formed in an endoscope (not shown). More specifically, the medical device 1 according to the present embodiment is a ligation device for ligating a target tissue inside the body.
  • the side on which the endoscope operation section for the operator to operate the endoscope is located is defined as the proximal side, and the side on which the tip section of the endoscope inserted into the body is located is the tip. Define as the side.
  • the medical device 1 is configured to include a clip unit (treatment tool) 10 provided on the distal end side and a treatment tool main body (applicator) 30 (see FIG. 8).
  • a clip unit (treatment tool) 10 provided on the distal end side
  • a treatment tool main body (applicator) 30 see FIG. 8
  • the clip unit 10 will be simply referred to as the clip 10 hereinafter.
  • the clip 10 is detachably connected to a distal end portion of a treatment tool body 30 described later.
  • FIG. 1 is a perspective view of a clip 10 according to this embodiment.
  • FIG. 2 is a perspective view of the arm member 11 of the clip 10 according to this embodiment.
  • FIG. 3A is a partial cross-sectional view of the arm member 11 in plan view.
  • FIG. 3B is a partial cross-sectional view of the arm member 11 in a side view.
  • the clip 10 includes an arm member 11, a pressing tube 31, and a connecting member (first link) 3.
  • the facing direction X in which the first arm 12 and the second arm 13 of the arm member 11 of the clip 10 face each other
  • the axial direction Y parallel to the axis C1 of the pressing tube 31, and the facing direction X.
  • An orthogonal direction Z orthogonal to each of the direction X and the axial direction Y is defined.
  • an axis C1 of the insertion portion 60 which will be described later, is regarded as an axis of the clip 10.
  • the arm member 11 has a first arm 12, a second arm 13, and an intermediate portion 14.
  • the first arm 12 and the second arm 13 extend from the base end side toward the tip end side and are arranged to face each other.
  • the intermediate portion 14 is located between the base end portion of the first arm 12 and the base end portion of the second arm 13.
  • the first arm 12 and the second arm 13 may be formed at positions symmetrical with respect to the axis C1.
  • the “natural state” means a state in which an external force does not act on the arm member 11.
  • a claw 12a extending toward the second arm 13 side is formed at the tip of the first arm 12.
  • a claw 13a extending toward the first arm 12 side is formed at the tip of the second arm 13.
  • the arm member 11 forms the first arm 12 and the second arm 13 by bending a metal material such as a leaf spring material such as stainless steel, and then forms the first arm 12 and the second arm 13. Are formed by intersecting. With this structure, the arm member 11 can slide along the inner peripheral surface of the pressing tube 31 when being drawn into the pressing tube 31.
  • a pair of protrusions 16 and 17 are formed on the intermediate portion 14 of the arm member 11. More specifically, the pair of protrusions 16 and 17 project orthogonally to the longitudinal direction in which the first arm 12 and the second arm 13 of the arm member 11 extend.
  • the pair of protrusions 16 and 17 may be formed at positions symmetrical with respect to the axis C1. Since the pair of protrusions 16 and 17 of the clip 10 are formed, the pair of protrusions 16 and 17 are more than the step portion 31b of the holding pipe 31 when the arm member 11 is retracted into the holding pipe 31, as described later. By digging into the inner wall on the base end side, the movement (advancement) of the arm member 11 with respect to the pressing pipe 31 can be limited.
  • the presser pipe 31 is formed in a cylindrical shape and has an inner diameter that allows the base end portion of the arm member 11 to enter. That is, the pressing tube 31 is formed with a lumen into which the first arm 12 and the second arm 13 of the arm member 11 can enter. Further, at least part of the connecting member 3 described later can also enter the lumen formed in the presser pipe 31.
  • a step portion 31b is formed that protrudes inward in the radial direction of the pressing tube 31 from the inner wall of the pressing tube 31.
  • the pressing tube 31 is formed to have a large diameter portion 31c located on the tip side of the step portion 31b and a small diameter portion 31d located on the base end side of the step portion 31b.
  • the large diameter portion 31c has a larger inner diameter than the small diameter portion 31d.
  • the large diameter portion 31c of the presser pipe 31 has an inner diameter such that the pair of protrusions 16 and 17 of the arm member 11 can advance and retract.
  • the small-diameter portion 31d of the pressing tube 31 has an inner diameter smaller than the width of the portion of the arm member 11 where the pair of protrusions 16 and 17 are formed. For this reason, as will be described later, when the arm member 11 is drawn into the holding pipe 31 and is located closer to the base end side than the step portion 31b, the pair of protrusions 16 and 17 of the arm member 11 cause the small diameter portion of the holding pipe 31 to move.
  • the pressing tube 31 has an outer diameter larger than the inner diameter of the sheath 66 of the insertion portion 60 described later.
  • These members including the arm member 11 that compose the clip 10 are made of a material such as a cobalt chromium alloy, titanium, or stainless steel.
  • the clip 10 is also configured so that it can be observed under MRI (Nuclear Magnetic Resonance Imaging) fluoroscopy.
  • the arm member 11 is obtained by punching a plate material formed of, for example, a cobalt chrome alloy into a shape in which the first arm 12 and the second arm 13, the intermediate portion 14, and the pair of protrusions 16 and 17 are developed in a plane shape. , Integrally formed.
  • the first arm 12 and the second arm 13 of the arm member 11 have an elastic restoring force that moves in the direction in which the respective tips are separated from each other, that is, in the direction in which the arm member 11 opens.
  • a tapered surface 31a is formed on the inner wall of the tip portion of the pressing tube 31 over the entire circumference.
  • the tapered surface 31a has a diameter that increases toward the tip side.
  • the pressing tube 31 and the locking portion 32 may be integrally formed of a material such as 64 titanium alloy (Ti-6AL-4V) or cobalt chrome alloy.
  • the connecting member (first link) 3 includes a tip portion 3a, a small diameter portion 3b, a hook portion 3c, a medium diameter portion 3d, a large diameter portion 3e, and a cutout portion. 3g, the base end part 3f, and the protrusion part 3h are formed.
  • the connecting member 3 is formed of a resin material having a predetermined strength by a method such as injection molding.
  • the connecting member 3 is configured to connect the arm member 11 of the clip 10 and the operation wire 62 described later.
  • the tip portion 3a of the connecting member 3 is configured to support a hook portion 3c for connecting the arm member 11, and its shape is not particularly limited.
  • the hook portion 3c is formed so as to project from the tip end portion 3a in a direction orthogonal to the longitudinal direction in which the connecting member 3 extends, and is hooked on a loop formed in the intermediate portion 14 of the arm member 11, whereby the arm member 11 is attached to the connecting member 3. Can be connected.
  • the small diameter portion 3b is formed by being connected to the base end side of the tip end portion 3a.
  • the small-diameter portion 3b is a portion of the connecting member 3 having the smallest outer diameter, and the small-diameter portion 3b is broken when an operation force amount of a predetermined amount or more is applied. In the present embodiment, for example, when a tensile force amount of 20 to 60 Newton is applied to the small diameter portion 3b, the small diameter portion 3b breaks.
  • the middle-diameter portion 3d and the large-diameter portion 3e are formed to have an outer diameter larger than that of the small-diameter portion 3b, and connect the tip end portion 3a and the base end portion 3f of the connecting member 3. In the present embodiment, since the outer diameter of the middle diameter portion 3d and the large diameter portion 3e is less than or equal to the inner diameter of the pressing tube 31, when the connecting member 3 moves with respect to the pressing tube 31, it can enter the pressing tube 31. ..
  • the base end portion 3f of the connecting member 3 is formed by bifurcating from the tip end side to the base end side. More specifically, the base end 3f is formed by a pair of spaced arms. As shown in FIG. 1, between the pair of arms of the base end portion 3f, a size is sufficient to allow a hook-shaped hook 62a (see FIG. 4A) formed at the tip of the operation wire 62 described later to enter. A hole having is formed. For example, when the hook 62a is inserted into the hole formed in the base end portion 3f, the outer peripheral surface of the hook 62a presses while contacting the inner peripheral surface of the hole, whereby the pair of arms of the base end portion 3f are pressed. Respectively elastically deform outward in the longitudinal axis direction of the connecting member 3. Therefore, the hook 62a can pass through the hole formed in the base end portion 3f and enter the cutout portion 3g described later.
  • a cutout portion 3g is formed by cutting a part of the base end portion 3f.
  • the cutout portion 3g has a size that can receive the hook 62a in a state where the hook 62a described later can enter through a hole formed in the base end portion 3f.
  • a protrusion 3h is formed on the outer peripheral surface of the large diameter portion 3e of the connecting member 3.
  • the connecting member 3 can be engaged with the pressing tube 31 at the position where the protrusion 3h is formed. With such a configuration, the connecting member 3 can restrict the elastic restoring force of the arm member 11 from moving the connecting member 3 with respect to the pressing tube 31.
  • the treatment instrument main body 30 is configured to include an insertion portion 60 and an operation portion 100.
  • the insertion portion 60 is located closer to the tip end side than the operation portion 100 and is connected to the tip end of the operation portion 100.
  • the operation part 100 is attached to the base end part of the insertion part 60.
  • the insertion portion 60 of the treatment instrument body 30 includes a sheath 66 and an operation wire (wire) 62.
  • the operation wire 62 is inserted into the sheath 66 so as to be able to move forward and backward.
  • the operation wire 62 is provided for transmitting to the clip 10 the amount of force with which the operator operates the operation unit 100 on the proximal end side (for example, the operation of pushing in the slider 102 and the operation of pulling back the slider 102).
  • the sheath 66 may be a coil sheath formed of stainless steel such as SUS301 having high compression strength.
  • a coil formed by closely winding an unillustrated wire in the axial direction Y can be used as the sheath 66.
  • the sheath 66 has flexibility and is strong against the compressive force in the axial direction Y.
  • the sheath 66 has an inner diameter such that the connecting member 3 cannot rotate with respect to the hook 62a when the sheath 66 is positioned inside the sheath 66 with the hook 62a and the notch 3g of the connecting member 3 engaged with each other. Is formed. More specifically, as shown in FIGS.
  • the connecting member 3 rotates in a direction intersecting the axis C1 direction with respect to the hook 62a, and the hook 62a and the connecting member 3 are engaged with each other. It does not mean that the connecting member 3 does not rotate with respect to the hook 62a at all unless the combined state is released.
  • the operation wire 62 is formed of, for example, a metal single wire or a twisted wire.
  • the operation wire 62 is configured by connecting a hook (second link) 62a, a shaft portion 62c, and a fixing portion 62b on the distal end side.
  • the fixing portion 62b is a cylindrical member made of a metal material such as stainless steel.
  • the operation wire 62 is fixed to the fixing portion 62b by various known methods such as bonding and welding.
  • the hook 62a and the fixed portion 62b are connected by a shaft portion 62c formed in a rod shape. Therefore, in the present embodiment, the operation wire 62, the hook 62a, the fixing portion 62b, and the shaft portion 62c are integrally formed.
  • the hook 62a can move forward and backward together with the operation wire 62 by the forward and backward movement of the operation wire 62.
  • the hook 62a is formed in a conical shape. As shown in FIGS. 7A and 7B, the hook 62a has an outer peripheral surface having an inclined surface shape in which the outer diameter gradually decreases toward the tip side.
  • the outer diameter of the base end surface of the hook 62a is larger than the diameter of the hole formed in the base end portion 3f when the base end portion 3f of the connecting member 3 is not elastically deformed. That is, in the state where the hook 62a is housed in the cutout 3g of the connecting member 3, the hook 62a does not come off from the cutout 3g only by the forward/backward movement of the operation wire 62.
  • the operation unit 100 includes an operation unit body (handle) 101, a slider (first operation unit) 102, and a wire adjusting member (second operation unit) 103. ..
  • the operation portion main body 101 is attached to the proximal end portion of the sheath 66.
  • the operation portion main body 101 is formed in a rod shape extending in the axial direction Y, and has a finger hook portion 101a at the base end portion.
  • a slit 101b extending in the axial direction Y is formed in the operation section body 101.
  • the slider 102 is provided so as to be inserted into the operation unit body 101.
  • the slider 102 is slidable (moves forward and backward) in the axial direction Y with respect to the operation portion main body 101.
  • the slider 102 is moved forward or backward in the axial direction Y, whereby the operation wire 62 and the hook 62a fixed to the tip of the operation wire 62 are moved forward or backward.
  • the arm member 11 of the clip 10 can be moved forward or backward together with the operation wire 62 by the operation of moving the operation wire 62 forward or backward.
  • the pair of first arm 12 and second arm 13 of the arm member 11 can be opened or closed.
  • the slider 102 is formed in a cylindrical shape. On the outer peripheral surface of the slider 102, a recess 102a is formed over the entire circumference. On the slider 102, a flange 102b, a recess 102a, and a flange 102c are formed in this order from the front end side to the base end side in the axial direction Y. The pair of collar portions 102b and 102c have an elliptical shape when viewed in the axial direction Y. As a result, the slider 102 can be easily gripped, and space can be saved when the operation unit 100 of the endoscope clip 1 is packed. The slider 102 engages with the slit 101b of the operation portion main body 101 to limit the movement range of the slider 102 in the axial direction Y with respect to the operation portion main body 101.
  • a wire adjusting member (second operation unit) 103 having a reel shape and a restriction unit 104 are formed.
  • the wire adjusting member 103 adjusts the length of the operation wire 62 provided between the slider 102 and the fixing portion 62b connected to the hook 62a by an operation different from the advancing/retreating operation of the slider 102 described later. can do.
  • the wire adjusting member 103 can adjust the distance from the slider 102 to the hook 62a.
  • the wire adjusting member (second operation unit) 103 includes a shaft portion 103a formed in a rod shape and a knob 103b fixed to the shaft portion 103a for rotating the shaft portion 103a.
  • the shaft portion 103a may be configured to be inserted into a hole formed in the recess 102a of the slider 102 of the operation portion 100, or may be integrally formed with the slider 102. That is, in the present embodiment, the wire adjusting member 103 and the slider 102 can integrally move back and forth along the direction of the axis C1. In other words, in the present embodiment, the wire adjusting member 103 and the slider 102 do not move relative to each other along the direction of the axis C1.
  • the operation wire 62 has its proximal end fixed to the shaft portion 103a through a through hole formed in the flange portion 102b of the slider 102.
  • the knob 103b of the wire adjusting member 103 can rotate the shaft portion 103a by a rotating operation in a clockwise or counterclockwise direction.
  • the shaft portion 103a also rotates in the clockwise direction, and a part of the operation wire 62 can be wound around the shaft portion 103a.
  • the knob 103b rotates counterclockwise to rotate the shaft portion 103a counterclockwise, and the operation wire 62 wound around the shaft portion 103a can be discharged.
  • the shaft portion 103a rotates together with the knob 103b, so that the slider 102 (more specifically, the shaft portion 103a of the wire operation member 103 fixed to the slider 102) and the fixing portion 62b connected to the hook 62a.
  • the length of the operation wire 62 provided between the and can be adjusted. In other words, the distance from the slider 102 to the hook 62a can be adjusted by rotating the shaft portion 103a together with the knob 103b.
  • a regulating portion 104 that regulates the rotating operation of the knob 103b is provided near the knob 103b of the wire adjusting member 103.
  • the specific configuration of the regulation unit 104 is not particularly limited, but the rotation operation of the knob 103b can be limited when the regulation unit 104 is not operated.
  • the knob 103b can be rotated by pushing the regulating portion 104. More specifically, the operator pushes the regulating portion 104 to a height equal to or lower than the height of the knob 103b from the surface of the slider 102, so that the knob 103 can pass over the regulating portion 104 and rotate.
  • the restricting portion 104 protrudes from the surface of the slider 102 to the same height as the knob 103b and comes into contact with the knob 103b. Counterclockwise rotation can be restricted. Therefore, by providing the restriction unit 104 in the operation unit 100 according to the present embodiment, it is possible to prevent the knob 103b from being erroneously operated at an unintended timing.
  • the clip case 40 is configured to be easily transported and to be prevented from being polluted by the external environment in the process of actually using the clip 10 according to the present embodiment after being manufactured.
  • FIG. 5A is a perspective view schematically showing the configuration of the clip case 40 according to the present embodiment.
  • FIG. 5B is an exploded view schematically showing the configuration of the clip case 40 according to this embodiment.
  • FIG. 5C is a plan view showing the internal structure of the lower case 42 of the clip case 40.
  • FIG. 5D is a cross-sectional view in side view showing the configuration of the clip case 40.
  • the clip case 40 is composed of an upper case 41 and a lower case 42 having the same shape and the same dimensions.
  • the upper case 41 and the lower case 42 can be made of, for example, various known resin materials having a certain hardness and being transparent.
  • the clip case 40 according to the present embodiment is not particularly limited in shape as long as the clip 10 can be suitably accommodated and the operator can easily hold the clip 10.
  • the clip case 40 may have a length of about 50 mm, a width of about 10 to 20 mm, and a thickness of about 5 mm.
  • the upper case 41 and the lower case 42 of the clip case 40 are connected by the three sets of the engaging claws 35 and the engaging holes 36 corresponding to each other.
  • the clip 5B in a state where the upper case 41 and the lower case 42 of the clip case 40 are connected to each other, inside the lumen 37 formed in the clip housing portion 33 formed in the lower case 42, At least the arm member 11 of the clip 10 can be accommodated.
  • the arm member 11 of the clip 10 is formed in the clip storage portion 33 of the lower case 42 in an open form in which the first arm 12 and the second arm 13 are separated from each other. It is housed in the inner cavity 37.
  • a groove 38 having a depth capable of accommodating the pressing tube 31 and the connecting member 3 is formed in the clip housing portion 33 at a position closer to the proximal end side than the inner cavity 37.
  • the groove 38 is formed with an inner diameter such that the base end 3f of the connecting member 3 can be elastically deformed when the hook 62a tries to enter the notch 3g from the base end 3f of the connecting member 3. There is.
  • the first arm 12 and the second arm 13 of the arm member may abut the tip surface of the inner cavity 37.
  • a compression portion 34 that can be pressed by an operator is continuously formed on the proximal side of the clip housing portion 33 of the clip case 40.
  • the compression portion 34 is configured to include a pair of legs 34A and 34B that are spaced apart from each other by a certain distance in the state where no external force acts. More specifically, the pair of legs 34A and 34B of the compression portion 34 are formed by being bent at a predetermined angle with respect to the direction of the longitudinal axis of the clip case 40 when no external force is applied. That is, the pair of legs 34A and 34B of the compression portion 34 are formed such that the distance between them is gradually increased from the distal end side toward the proximal end side in a state where no external force acts.
  • the pair of legs 34A and 34B of the compression portion 34 are provided with a groove 46 and an inlet portion 45 which are formed continuously with the above-described groove 38.
  • the groove 46 is formed to have a larger inner diameter than the groove 38 on the base end side of the groove 38. Further, the groove 46 is formed by being bent according to the bent shape of the pair of legs 34A, 34B.
  • the groove 38 is formed with an inner diameter such that the hook 62a, the fixing portion 62b, and the shaft portion 62c described above can enter and the sheath 66 cannot enter.
  • the groove 38 is formed to have an inner diameter larger than the width of each of the hook 62a, the fixed portion 62b, and the shaft portion 62c.
  • the groove 46 may be formed to have an inner diameter larger than the width of each of the hook 62a, the fixing portion 62b, the shaft portion 62c, and the sheath 66.
  • a step portion 48 is formed at the boundary between the groove 38 and the groove 46, as shown in FIG. 5D.
  • the pair of legs 34 ⁇ /b>A and 34 ⁇ /b>B of the compression section 34 has an opening 45 formed on the proximal side of the groove 46. As shown in FIGS. 5B and 5C, the opening 45 is formed such that the inner diameter thereof gradually increases from the distal end side toward the proximal end side. With this configuration of the opening 45, the operation wire 62 can be easily inserted into the clip case 40.
  • a plurality of hemispherical concave portions 47 are formed on the outer peripheral surfaces of the pair of legs 34A and 34B of the compression portion 34.
  • these recesses 47 act as anti-slip when compressing the operator compression unit 34.
  • the same effect can be obtained by forming a plurality of protrusions instead of the plurality of hemispherical recesses 47 on the outer peripheral surfaces of the pair of legs 34A and 34B of the compression portion 34.
  • FIGS. 6A to 6E an operation of mounting the clip 10 according to the present embodiment on the operation portion main body 30 will be described as preparation before the treatment of the target tissue in the body.
  • the operator inserts the treatment instrument main body 30 into the clip case 40 until the sheath 66 contacts the step portion 48 of the clip case 40.
  • a part of the operation wire 62 is wound around the shaft portion 103a of the wire adjusting member 103 (see FIG. 4B). Therefore, as shown in FIG.
  • the hook 62a is housed inside the sheath 66 even when the slider 102 of the operation unit 100 is in contact with the tip surface 101a of the slit 101b. Further, in the wire adjusting member 103, the rotating operation by the knob 103b is restricted by the restricting portion 104.
  • the operator grips and compresses the pair of legs 34A and 34B of the compression portion 34 formed on the proximal end side of the clip case 40, whereby the compression portion 34 elastically deforms.
  • the sheath 66 can move forward and backward along the direction of the axis C1 while being held by the pair of legs 34A and 34B. Can not be.
  • the hook 62a is housed inside the sheath 66.
  • the rotation operation of the knob 103b is restricted by the restriction section 104, and a part of the operation wire 62 is wound around the shaft section 103a of the wire adjusting member 103.
  • the operator pushes in the regulating portion 104 of the wire adjusting member 103 and rotates the knob 103b counterclockwise.
  • the regulating portion 104 of the wire adjusting member 103 By pushing the regulating portion 104 of the wire adjusting member 103, the regulation of the rotating operation of the knob 103b by the regulating portion 104 is released, and the operator can rotate the knob 103b.
  • the angle at which the operator rotates the knob 103b of the wire adjusting member 103 counterclockwise is not particularly limited.
  • the operator may push the regulating portion 104 of the wire adjusting member 103 and rotate the knob 103b counterclockwise at a predetermined angle (for example, 90 degrees).
  • the shaft portion 103a of the wire adjusting member 103 rotates counterclockwise together with the knob 103b, and a part of the operation wire 62 wound around the shaft portion 103a is discharged.
  • the operation wire 62 wound around the shaft portion 103a may be discharged in about several millimeters.
  • the operating wire 62 is not substantially wound around the shaft portion 103a of the wire adjusting member 103.
  • the hook 62a provided on the distal end side of the operating wire 62 advances together with the operating wire 62 and projects from the opening on the distal end side of the sheath 66. Further, the hook 62a passes through the hole formed in the base end portion 3f of the connecting member 3 and enters the cutout portion 3g of the connecting member 3. As a result, as shown in FIG. 6C, the hook 62 a is engaged with the cutout portion 3 g of the connecting member 3, and the operating wire 62 and the clip 10 are connected by the connecting member 3. At this time, the connecting member 3 that connects the operation wire 62 and the clip 10 projects from the opening on the distal end side of the sheath 66.
  • the knob 103b can get over the regulation unit 104 in the process of rotating the knob 103b counterclockwise while the operator pushes in the regulation unit 104. At this time, when the operator releases the pressing force on the restriction portion 104, the restriction portion 104 projects from the surface of the slider 102 and abuts on the knob 103b, as shown in FIG. 6D. Therefore, when the operator does not operate the restriction unit 104, the clockwise rotation of the knob 103b is restricted. In other words, the state in which the connecting member 3 connecting the operating wire 62 and the clip 10 projects from the opening on the distal end side of the sheath 66 is maintained.
  • the hook 62a is projected from the sheath 66
  • the distance from the tip surface to the tip of the hook 62a is defined as the first distance from the slider 102 to the hook 62a.
  • the length of the operation wire 62 from the shaft portion 103a provided in the recess 102a of the slider 102 to the fixed portion 62b connected to the hook 62a is defined as the first length of the operation wire 62.
  • the hook 62a is engaged with the cutout portion 3g of the connecting member 3 when the slider 102 is advanced along the slit 101b to a position where it abuts on the tip surface 101a of the slit 101b.
  • the present invention is not limited to this.
  • the hook 62a is attached to the notch 3g of the connecting member 3 before the slider 102 abuts the tip surface 101a. It is also possible to enter and be engaged. At this time, when the hook 62a enters and is engaged with the notch 3g of the connecting member 3, the position of the slider 102 in the operation unit 100 in the slit 101b can be regarded as the most advanced position of the slider 102.
  • the connecting member 3 that connects the operation wire 62 and the clip 10 when the connecting member 3 that connects the operation wire 62 and the clip 10 is located outside the sheath 66, the connecting member 3 extends along the direction indicated by the arrow D in the axis C1 direction. It is possible to rotate in the direction intersecting with. Further, when the connecting member 3 is located outside the sheath 66 and is rotated in a direction intersecting the axis C, the hook 62a can be pulled out from the side of the cutout portion 3g of the connecting member 3.
  • the connecting member 3 is positioned relative to the hook 62a. It is formed with an inner diameter such that it cannot rotate. In other words, when the connecting member 3 that connects the clip 10 and the operation wire 62 is located inside the sheath 66, the sheath 66 maintains the engagement state between the clip 10 and the operation wire 62.
  • the used clip 10 can be easily removed from the treatment instrument body 30 and another clip 10 can be replaced.
  • the clip 10 when the clip 10 is attached to the treatment tool body 30 and the connecting member 3 projects from the opening on the distal end side of the sheath 66, the clip 10 may unintentionally drop off from the treatment tool body 30. ..
  • the operator attaches the clip 10 to the treatment instrument body 30 and then is provided on the slider 102.
  • the wire adjusting member 103 By operating the wire adjusting member 103, at least a part of the connecting member 3 can be housed inside the sheath 66.
  • the operator pushes in the restricting portion 104 of the wire adjusting portion 103 and rotates the knob 103b clockwise to rotate the shaft portion 103a of the wire adjusting portion 103 clockwise. Can be rotated.
  • a part of the operation wire 62 is wound around the shaft portion 103a of the wire adjusting portion 103, and the hook 62a and the hook 62a provided at the tip of the operation wire 62 are engaged.
  • the joined connecting member 3 moves to the proximal end side with respect to the sheath 66. That is, the clip 10 engaged with the operation wire 62 moves to the proximal end side with respect to the sheath 66.
  • the slider 102 of the operation unit 100 is maintained at the most advanced position in contact with the tip surface 101a of the slit 101b.
  • FIG. 6E shows an example in which the proximal end surface of the pressing tube 31 is located closer to the distal end side than the distal end surface of the sheath 66 and is spaced apart from each other. However, the proximal end surface of the pressing tube 31 contacts the distal end surface of the sheath 66. May be.
  • the slider 102 In this state, the slider 102 is in contact with the tip surface 101a of the slit 101b, and therefore cannot move further. Therefore, the hook 62a and the connecting member 3 that are connected to the operation wire 62 and are housed in the sheath 66 do not project from the distal end side opening of the sheath 66. That is, in the present embodiment, by maintaining the state where the distance from the slider 102 to the hook 62a is the second distance, it is possible to prevent the clip 10 from unintentionally dropping from the treatment tool body 30.
  • the present invention is not limited to this.
  • the knob 103b may automatically rotate clockwise and return to the initial state shown in FIG. 4A.
  • the operator can return the regulation unit 104 from the pushed position to the initial position (state). That is, the restricting portion 104 is located at a position protruding from the recess 102a of the slider 102, and can restrict the rotating operation of the knob 103b of the wire adjusting member 103 again. As a result, the operation wire 62 is not wound around the shaft portion 103a of the wire length adjusting portion 103 any more.
  • the second distance from the slider 102 to the hook 62a is defined as the second distance from the slider 102 to the hook 62a.
  • the length of the operation wire 62 from the shaft portion 103a provided in the recess 102a of the slider 102 to the fixed portion 62b connected to the hook 62a is defined as the second length of the operation wire 62.
  • the second distance and the second length are smaller than the above-described first distance and the first length, respectively.
  • the operator rotates the knob 103b of the wire adjusting member 103 in the clockwise direction to fix the wire adjusting member 103 from the shaft portion 103a to the hook 62a.
  • the length of the operation wire 62 up to the portion 62b can be changed from the first length to the second length.
  • the knob 103b of the wire adjusting member 103 by rotating the knob 103b of the wire adjusting member 103, the distance from the slider 102 to the hook 62a can be changed from the first distance to the second distance.
  • the engaging portion between the hook 62a and the connecting member 3 can be housed inside the sheath 66, and the engaged state between the hook 62a and the connecting member 3 can be maintained.
  • the operator releases the force of compressing the compression portion 34 of the clip case 40 while the engagement between the clip 10 and the operation wire 62 is maintained, and the operation portion 100 is removed.
  • the grip portion is grasped, and the insertion portion 60 of the treatment instrument body 30 to which the clip 10 is attached is removed from the clip case 40.
  • the proximal end surface of the pressing tube 31 is in contact with the distal end surface of the sheath 66.
  • the slider 102 In this state, in the operation portion 100 on the proximal end side, the slider 102 is in the most advanced position where it abuts on the distal end surface 101a of the slit 101b, and the rotation movement of the knob 103b of the wire adjustment member 103 is regulated by the regulation portion 104. There is.
  • the elastic restoring force of the first arm 12 and the second arm 13 of the arm member 11 of the clip 10 has an action of moving the pressing tube 31 to the base end side. Therefore, as shown in FIG. 8, the pressing tube 31 is in contact with the tip of the sheath 66. However, since the outer diameter of the pressing tube 31 is larger than the inner diameter of the sheath 66, the pressing tube 31 does not enter the sheath 66.
  • the operator inserts an endoscope (not shown) into the patient's body. Then, the operator can insert the medical device 1 from the proximal end portion of the channel of the endoscope and project the medical device 1 from the distal end portion of the channel of the endoscope.
  • the first arm 12 and the second arm 13 of the arm member 11 are maintained in the closed state by the operator's operation such as holding the slider 102. At that time, a part of the intermediate portion 14 located on the base end side of the arm member 11 is located inside the large diameter portion 31 c of the pressing tube 31.
  • the arm member 11 transits from the closed form to the open form.
  • the slider 102 is in the most advanced position in contact with the tip surface 101a of the slit 101b.
  • the pressing tube 31 has a proximal end surface in contact with the distal end surface of the sheath 66.
  • the operator can confirm the size of the target tissue T and the opening width of the arm member 11. For example, when the opening width of the arm member 11 (width between the first arm 12 and the second arm 13) is smaller than the size of the target tissue T, the operator operates the operation unit 100 to open the opening width of the arm member 11. Can be adjusted.
  • the clip 10 moves forward and backward together with the operation wire 62. That is, the first arm 12 and the second arm 13 of the arm member 11 of the clip 10 can move relative to the pressing tube 31 by advancing and retracting together with the operation wire 62. As a result, the first arm 12 and the second arm 13 of the arm member 11 are in contact with the tapered surface 31a provided on the tip end side of the pressing tube 31, while the opening width of the arm member 11 between them is increased or decreased. As shown in FIG.
  • the arm member 11 moves toward the base end side of the intermediate portion 14 (the position where the first arm 12 and the second arm 13 intersect with each other). Part) enters into the large diameter portion 31c of the presser pipe 31, and the first arm 12 and the second arm 13 are separated from each other in the radial direction of the arm member 11. As a result, as shown in FIG. 9, the operator can enlarge (adjust) the opening width of the arm member 11 according to the size of the target tissue T.
  • the holding pipe 31 is not moved. It does not cut into the inner wall. Therefore, the operator can push the slider 102 toward the distal end side to move the arm member 11 toward the distal end side and adjust the distance between the first arm 12 and the second arm 13.
  • the operator can operate the endoscope (not shown), adjust the orientation and the posture of the arm member 11 of the clip 10, and press the arm member 11 toward the target tissue T.
  • the target tissue T can be positioned between the first arm 12 and the second arm 13 of the arm member 11 in the open configuration.
  • the operator confirms that the target tissue T is located between the first arm 12 and the second arm 13, the operator operates the endoscope to move the target tissue with the first arm 12 and the second arm 13 of the arm member 11. T can be held.
  • the operator grips the operation section main body 101 and pulls back the slider 102.
  • the operation wire 62 and the first arm 12 and the second arm 13 move together to the base end side.
  • the first arm 12 and the second arm 13 contact the tapered surface 31 a provided on the distal end side of the pressing tube 31 in a state where the intersection of the first arm 12 and the second arm 13 enters the pressing tube 31.
  • the first arm 12 elastically deforms toward the second arm 13 side
  • the second arm 13 elastically deforms toward the first arm 12 side.
  • the tip end of the first arm 12 and the tip end of the second arm 13 approach each other, and the opening width of the arm member 11 decreases, whereby the arm member 11 transitions from the open configuration to the closed configuration.
  • the base end portion of the arm member 11 including the intermediate portion 14 is pulled back to the base end side in the presser pipe 31. ..
  • the operator pushes the slider 102 toward the tip side until the pair of protrusions 16 and 17 provided at the base end portion of the arm member 11 come into contact with the step portion 31b in the pressing tube 31, whereby the arm is moved.
  • the member 11 can be moved to the tip side.
  • the operator pushes the slider 102 toward the tip side until the pair of protrusions 16 and 17 of the arm member 11 come into contact with the step portion 31b, whereby the arm member 11 can be changed to the open state.
  • the operator can re-grasp the target tissue T by using the arm member 11. That is, in the process of pulling back the slider 102 to the above-described state, the operator can operate the endoscope to make the clip 10 face the target tissue T again. After that, the target tissue T can be grasped by the clip 10 again by the procedure described above.
  • the pair of protrusions 16 and 17 provided on the arm member 11 causes the step portion 31b in the presser tube 31 to move.
  • the slider 102 can be pulled back to the base end side until the vehicle gets over and is positioned in the small diameter portion 31d. In this state, the pair of protrusions 16 and 17 bite into the inner wall of the small-diameter portion 31d of the holding tube 31 to restrict the arm member 11 from moving toward the tip side with respect to the holding tube 31.
  • the arm member 11 in the closed configuration holds the target tissue T.
  • the root of the target tissue T is bound by the first arm 12 and the second arm 13, and the distance between the first arm 12 and the second arm 13 is substantially zero. It is also included in the closed form of.
  • the engaging portion between the hook 62a and the connecting member 3 is moved inside the sheath 66 toward the proximal end side.
  • FIG. 11A when the pair of protrusions 16 and 17 provided on the arm member 11 are pulled back to the position projecting from the opening on the proximal end side of the pressing tube 31, the proximal end surface of the pressing tube 31 is contacted and engaged. To be done. That is, even if the amount of force for moving the arm member 11 to the proximal end side of the pressing tube 31 is released, the pair of protrusions 16 and 17 is locked in the distal end side with respect to the proximal end surface of the pressing tube 31. is there.
  • the arm member 11 is restricted from moving toward the distal end side with respect to the pressing tube 31, and the state of holding the target tissue T in the closed form is locked.
  • the hook portion 3 c hooked on the intermediate portion 14 of the arm member 11 is located closer to the base end side than the base end side opening of the pressing tube 31 and is located inside the sheath 66.
  • the operator separates the clip 10 ligating the target tissue T from the treatment instrument body 30. Specifically, the operator further pulls the slider 102 back to the base end side in the locked state in which the pair of projections 16 and 17 is locked to the base end surface of the pressing tube 31 at the tip end side, and thus the slider 102
  • the amount of operating force reaches a predetermined value or more
  • the amount of tensile force acting on the small diameter portion 3b of the connecting member 3 exceeds the tensile strength at which the small diameter portion 3b breaks.
  • the small-diameter portion 3b is broken, and as shown in FIG.
  • the connecting member 3 has a distal end portion 3a, a hook portion 3c, and a portion of the small-diameter portion 3b connected to the arm member 11.
  • a part of the small-diameter portion 3b, the medium-diameter portion 3d, the large-diameter portion 3e, the cutout portion 3g, the base end portion 3f, and the protruding portion 3h are positioned inside the sheath 66 in a state of being engaged with the hook 62a.
  • the arm member 11 of the clip 10 tightly binds the target tissue T in the closed state in which the opening width of the first arm 12 and the second arm 13 is substantially zero.
  • the operator can operate the endoscope and take out the medical device 1 from the channel of the endoscope. After that, the operator takes necessary measures and ends the series of procedures.
  • the operator can treat the other target tissue T using the medical device 1 by mounting the new clip 10 on the treatment tool body 30. Specifically, the operator pushes the slider 102 toward the tip side until the slider 102 contacts the tip surface 101a of the slit 101b. After that, the regulating portion 104 provided on the slider 102 is pushed in, and the knob 103b of the wire adjusting member 103 is rotated counterclockwise, so that the operation wire 62 wound around the shaft portion 103a of the wire adjusting member 103 is discharged. ..
  • the length of the operation wire 62 from the shaft portion 103a of the wire adjusting member 103 to the fixed portion 62b connected to the hook 62a is changed from the second length to the first length.
  • the distance from the tip surface of the slider 102 to the tip of the hook 62a is changed from the second distance to the first distance.
  • the operator projects a part of the connecting member 3 engaged with the hook 62a from the opening on the distal end side of the sheath 66.
  • the operator removes a part of the connecting member 3 from the hook 62a, and then sterilizes the treatment instrument main body 30 as necessary, and the present embodiment.
  • the new clip 10 can be attached to the treatment instrument body 30 by the procedure shown in FIG.
  • the wire adjusting member 103 is arranged on the slider 102 of the operation unit 100 on the proximal end side. By pushing the slider 102, the operator can change the distance from the slider 102 to the hook 62a by operating the wire adjusting member 103 in a state where the slider 102 is in contact with the tip surface 101a of the slit 101b.
  • the clip 10 can be reloadable.
  • the operator can move the slider 102 forward and backward to move the arm member 11 together with the operation wire 62 forward and backward with respect to the holding tube 31.
  • the operator moves the slider 102 forward and backward until the pair of protrusions 16 and 17 formed on the base end side of the arm member 11 come into contact with the step portion 31b of the pressing tube 31, whereby the first arm is moved.
  • the opening width between 12 and the second arm 13 can be readjusted.
  • the medical device 1 according to the present embodiment when the arm member 11 is used to re-grip the target tissue T, the engagement between the hook 62a and the notch 3g of the connecting member 3 is unintentionally released. It will not be done.
  • both the reloadable operation of the clip 10 and the operation of re-grabbing the target tissue T with respect to the treatment tool body 30 can be achieved.
  • the wire adjusting member 103 has a simple configuration including the shaft portion 103a and the knob 103b, and is easy to manufacture, so that the medical device 1 can be configured at low cost.
  • FIG. 12A is a partial cross-sectional view schematically showing the configuration of the medical device 2 according to the second embodiment of the present invention.
  • FIG. 12B is an enlarged cross-sectional view schematically showing the configuration of part of the medical device 2 according to this embodiment.
  • 12C is a radial cross-sectional view taken along the line XIIC-XIIC in FIG. 12B as seen from the proximal end side of the medical device 2.
  • FIG. 12D is a perspective view showing the configuration of the wire adjusting member 203 in the medical device 2 according to this embodiment.
  • 13A to 15C are diagrams showing an operation of treating the target tissue T using the medical device 2 according to the present embodiment.
  • the medical device 2 according to the present embodiment has an operation unit 200 instead of the operation unit 100, as compared with the medical device 1 according to the first embodiment described above.
  • the medical device 2 has a wire adjusting member 203 having a different configuration from the wire adjusting member 103 according to the above-described first embodiment.
  • the other configurations of the medical device 2 according to the present embodiment are the same as those of the medical device 1 according to the first embodiment described above, and therefore, the same reference numerals are given in the drawings, and the description thereof will be omitted.
  • the lumen 205 is formed along the direction of the axis C1.
  • the medical device 2 includes a wire adjusting member (second operation unit) 203 including a main body 207, a knob 206, and two protrusions 204.
  • a part of the inner wall of the slider 202 is cut off along the direction of the axis C1 within a range where the inner cavity 205 of the slider 202 is formed, whereby a pair of tip recesses 208A and a pair of tip recesses 208A are formed.
  • a base end recess 208B is formed.
  • the pair of tip recesses 208A are located closer to the tip side than the pair of base recesses 208B along the direction of the axis C1.
  • the body 207 of the wire adjusting member 203 is a hollow pipe-shaped member having an outer diameter smaller than the inner diameter of the inner cavity 205. That is, the main body 207 can be inserted into the inner cavity 205 formed in the slider 202.
  • the main body 207 can be configured using, for example, a resin material having a certain rigidity.
  • a pair of tail portions 207A and 207B is formed by cutting off a part of the main body 207 on the base end side. Further, as will be described later, in order to connect the operation wire 62 to the wire adjusting member 203, a hole (not shown) into which the operation wire 62 can be inserted is formed on the tip side of the main body 207.
  • a pair of protrusions 204 is formed on the pair of tail portions 207A and 207B of the main body 207 so as to project radially outward from the outer peripheral surface.
  • the pair of protrusions 204 can enter and engage the distal recess 208A and the proximal recess 208B.
  • the method of forming the pair of protrusions 204 on the main body 207 is not particularly limited.
  • the pair of protrusions 204 may be formed by adhering to the pair of tail portions 207A and 207B of the main body 207, or may be formed integrally with the main body 207.
  • the pair of protrusions 204 are formed in a conical shape, but the present invention is not limited to this.
  • the pair of protrusions 204 may be engaged with the proximal recess 208B or the distal recess 208A formed in the inner cavity 205 of the slider 202, and the specific shape is not particularly limited.
  • the pair of distal end concave portions 208A and the pair of proximal end concave portions 208B formed in the inner cavity 205 are formed at two locations on the inner wall of the inner cavity 205 of the slider 202, respectively, in accordance with the shape of the pair of protrusions 204.
  • the tip recessed portion 208A and the base end recessed portion 208B may be formed around the entire circumference of the inner wall of the slider 202 in the circumferential direction.
  • the wire adjusting member 203 has a knob 206 formed on the outer peripheral surface of the main body 207 on the distal end side.
  • the knob 206 can be moved back and forth with respect to the slider 202 by performing a forward and backward operation while being gripped by an operator.
  • the knob 206 may be integrally formed of the same material as the main body 207, or may be formed with the main body 207 and then connected by the shaft portion 206a. As shown in FIG. 12C, a concavo-convex pattern may be formed on the tip end surface and the base end surface of the knob 206 to prevent slippage.
  • the proximal end of the operation wire 62 is inserted and fixed in a hole (not shown) formed on the distal end side of the main body 207.
  • the base end of the operation wire 62 may be fixed to the main body 207, and the shape of the hole formed on the distal end side of the main body 207 is not particularly limited. For example, it may be a hole penetrating the main body 207 in the direction of the axis C1 or may not be penetrating the main body 207.
  • the proximal end of the operation wire 62 may be fixed to the distal end surface 207C of the main body 207.
  • the method of fixing the operation wire 62 to the main body 207 is not particularly limited.
  • the base end of the operation wire 62 can be fixed to the main body 207 by various known methods, such as brazing and bonding with an adhesive. Therefore, when the operator moves the main body 207 forward and backward with respect to the slider 202, the operation wire 62 can move forward and backward with respect to the slider 202 together with the main body 207.
  • the operator holds the knob 206 and moves the main body 207 forward and backward (slides) along the direction of the axis C1 to move the wire adjusting member 203 into the lumen 205. Can be inserted or withdrawn. In other words, the distance from the tip of the slider 202 to the tip of the hook 62a can be adjusted by operating only the wire adjusting member 203 without operating the slider 202.
  • the main body when the slider 202 is in the slit 201b of the operation portion main body 201, the main body is in the most advanced position, that is, in the state of being in contact with the tip surface 201a of the slit 201b.
  • the pair of protrusions 204 of 207 are engaged in the proximal recess 208B in the inner cavity 205 of the slider 202, the distance from the tip surface of the slider 202 to the tip of the hook 62a is the first distance between the slider 202 and the hook 62a. Two distances.
  • the tip of the slider 202 is The distance from the surface to the tip of the hook 62a is the first distance between the slider 202 and the hook 62a (see FIG. 13A).
  • the operator adjusts the distance between the slider 202 and the hook 62a to the first distance and the second distance only by operating the wire adjusting member 203 without operating the slider 202. can do.
  • the first distance between the slider 202 and the hook 62a is larger than the second distance.
  • the hook 62a projects from the opening on the distal end side of the sheath 66, and the slider 202 and the hook 62a are separated from each other.
  • the hook 62a is located closer to the base end side than the opening on the distal end side of the sheath 66, that is, in a position to be accommodated in the sheath 66.
  • the operator does not operate the slider 202 without operating the slider 202 when the slider 202 is in the most advanced position in the slit 201b of the operation portion main body 201, that is, in the state of being in contact with the tip end surface 201a of the slit 201b.
  • the wire adjusting member 203 By merely operating the wire adjusting member 203, it is possible to cause the hook 62a to protrude from the opening on the distal end side of the sheath 66 and to store the hook 62a in the sheath 66.
  • the operation wire 62 and the wire adjustment member 203 move forward and backward, so that the operation wire 62 moves forward and backward relative to the slider 202.
  • the operation wire 62 is connected to the hook 62a from the position fixed to the main body 207 of the wire adjusting member 203 along the direction of the axis C1.
  • the length of the operation wire to the fixed portion 62b is constant.
  • the pair of protrusions 204 are engaged with the inner cavity 205 formed in the slider 202, so that the wire adjusting member 203 and the slider 202 are not moved relative to each other. it can.
  • the wire adjusting member 203 moves forward and backward together with the slider 202.
  • FIGS. 12A to 15C The operation of the medical device 2 according to the present embodiment will be described below with reference to FIGS. 12A to 15C. Specifically, with reference to FIGS. 12A to 13C, an operation of mounting the clip 10 in the medical device 2 on the treatment instrument main body 30A will be described. A procedure for ligating the target tissue T using the medical device 2 will be described with reference to FIGS. 14 to 15C.
  • the treatment tool main body 30A is inserted into the clip case 40 until it comes into contact with the.
  • the hook 62 a is housed inside the sheath 66.
  • the operation unit 200 in the wire adjusting member 203, the pair of protrusions 204 of the main body 207 are engaged with the base end recess 208B in the inner cavity 205 of the slider 202. Further, the slider 202 is located at the most advanced position in the slit 201b so as to come into contact with the front end surface 201a. In this state, the distance between the slider 202 of the operation unit 200 and the hook 62a is the second distance.
  • the operator grips and compresses the pair of legs 34A and 34B of the compression portion 34 of the clip case 40, so that the position of the sheath 66 relative to the clip case 40 is fixed. Hold it.
  • the operator grips the knob 206 of the wire adjusting member 203 and moves (slides) the main body 207 toward the distal end side along the axis C1 direction.
  • the pair of protrusions 204 engaged with the base end recess 208B of the inner cavity 205 of the slider 202 try to move to the distal end side in a state of contacting and pressing the inner wall of the base end recess 208B. ..
  • the repulsive force from the inner wall of the base end concave portion 208B acts on the pair of protrusions 204 and the pair of tail portions 207A and 207B of the wire adjusting member 203, so that the pair of tail portions 207A and 207B is in the radial direction of the operation portion 200. Pressed inward. As a result, the distance between the pair of tail portions 207A and 207B decreases, and the tail portions 207A and 207B come closer to each other. In other words, the pair of tail portions 207A and 207B formed on the main body 207 of the wire adjusting member 203 is in a bent state, and the width of the main body 207 on the base end side in the radial direction decreases.
  • the wire adjusting member 203 can move toward the distal end side with respect to the slider 202 in the inner cavity 205 by the pair of protrusions 204 of the main body 207 overriding the base end concave portion 208B.
  • the pair of protrusions 204 is formed in the inner cavity 205 while the pair of tail portions 207A and 207B are bent.
  • the wire adjusting member 203 is moved toward the tip side with respect to the slider 202 until the wire adjusting member 203 enters and is engaged with the recess 207A. At this time, the pair of tail portions 207A and 207B return to the state of being separated from each other by the elastic restoring force.
  • the operating wire 62 fixed to the main body 207 of the wire adjusting member 203 and the hook 62a connected to the distal end side of the operating wire 62 are moved together with respect to the slider 202 toward the distal end side.
  • the hook 62a projects from the distal end side opening of the sheath 66 and enters the notch 3g of the connecting member 3, whereby the hook 62a and the connecting member 3 engage with each other.
  • the distance between the slider 202 of the operation unit 200 and the hook 62a changes from the second distance to the first distance that is larger than the second distance.
  • the state where the slider 202 is in contact with the tip surface 201a in the slit 201b is maintained.
  • the operator holds the knob 206 of the wire adjusting member 203 without operating the slider 202, and slides the main body 207 toward the base end side along the direction of the axis C1.
  • the pair of protrusions 204 of the main body 207 move over the distal end concave portion 208A in the inner cavity 205 and are moved to the proximal end side while maintaining the state where the slider 202 is in contact with the distal end surface 201a of the slit 201b. ..
  • the wire adjusting member 203 is moved to the proximal end side until the pair of protrusions 204 enter and are engaged with the proximal recess 208B.
  • the amount of movement of the main body 207 to slide toward the distal end side or the proximal end side is not particularly limited, but may be, for example, about several millimeters.
  • the wire adjusting member 203 is pulled back to the base end side together with the operation wire 62 by the movement of the body 207 to the base end side.
  • the engaging portion between the hook 62a and the connecting member 3 is retracted and accommodated in the sheath 66.
  • the distance between the slider 202 of the operation unit 200 and the hook 62a changes from the first distance to the second distance.
  • the state where the slider 202 is in contact with the tip surface 201a in the slit 201b is maintained.
  • the operation wire 62 is fixed to the main body 207 of the wire adjusting member 203, even if the operation wire 62 is moved along the axis C1 direction of the main body 207, it is between the main body 207 and the fixed portion 62b connected to the hook 62a.
  • the length of the operation wire 62 is constant.
  • the operation wire 62 also moves back and forth with respect to the slider 202. Therefore, according to the wire adjusting member 203 of the present embodiment, the length of the operation wire 62 between the tip surface of the slider 202 and the fixed portion 62b can be adjusted.
  • the operator releases the compression of the compression section 34 of the clip case 40, grasps the operation section 100, and removes the insertion section 60 from the clip case 40. In this process, it is not necessary for the operator to pull back the slider 202 to the base end side.
  • the clip 10 according to the present embodiment can be attached to the treatment instrument main body 30A.
  • the pair of protrusions 204 of the wire adjusting member 203 are engaged in the base end concave portion 208B, and the slider 202 abuts on the tip end surface 201a of the slit 201b.
  • the proximal end surface of the pressing tube 31 contacts the distal end surface of the sheath 66 on the distal end side of the medical device 2 removed from the clip case 40.
  • the pair of protrusions 204 formed on the main body 207 of the wire adjusting member 203 may be formed of a material that is elastically deformable. More specifically, when the operator grips the knob 206 of the wire adjusting member 203 and moves the main body 207 toward the tip side along the direction of the axis C1, the pair of tail portions 207A and 207B of the main body 207 do not deform.
  • the pair of protrusions 204 may be pressed by the inner wall of the inner cavity 205 of the slider 202 and elastically deformed to be in a crushed state. Then, when the wire adjusting member 203 moves toward the tip side along the direction of the axis C1 by the operation of the operator, when the pair of protrusions 204 enter the tip concave portion 208A, the elastic restoring force restores the cone shape, It may engage with the tip recess 208A.
  • the operator can operate the endoscope, adjust the orientation and posture of the arm member 11 of the clip 10, and press the arm member 11 toward the target tissue T.
  • the pair of protrusions 204 of the main body 207 of the wire adjusting member 203 engages with the proximal recess 208B in the inner cavity 205 of the slider 202, and the slider 202 contacts the distal end surface 201a of the slit 201b. The contact state is maintained.
  • the width of the arm member 11 of the clip 10 is appropriate for the size of the target tissue T
  • the present invention is not limited to this.
  • the operator operates the slider 202 to change the width of the arm member 11 as in the first embodiment. It can be adjusted appropriately.
  • the operator grasps the operation section main body 201 and moves the slider 202 to the proximal end side. Pull back. Therefore, the front end of the first arm 12 and the front end of the second arm 13 approach each other, and the opening width of the arm member 11 is reduced. That is, with the target tissue T positioned between the first arm 12 and the second arm 13, the arm member 11 transitions from the open configuration to the closed configuration. In this process, since the operator does not operate the wire adjusting member 203, the state in which the pair of protrusions 204 is engaged with the proximal recess 208B in the inner cavity 205 of the slider 202 is maintained.
  • the operator slides until the pair of protrusions 16 and 17 provided on the proximal end side of the arm member 11 come into contact with the step portion 31b in the pressing tube 31.
  • the arm member 11 By pushing 202 toward the tip side, the arm member 11 can be moved to the tip side.
  • the operator pushes the slider 202 toward the tip side until the pair of protrusions 16 and 17 of the arm member 11 come into contact with the step portion 31b, so that the arm member 11 can transition to the open state.
  • the operator can re-grasp the target tissue T by using the arm member 11. Therefore, in the present embodiment, the operator can repeatedly re-grasp the target tissue T until it can confirm that the target member T is grasped by the arm member 11 in a desired state.
  • the pair of projections 16 and 17 provided on the proximal end side of the arm member 11 causes the proximal end side of the pressing tube 31 to move.
  • the slider 202 of the operation unit 200 is pulled back to the base end side until it is located closer to the base end side than the opening.
  • the target tissue T is held by the first arm 12 and the second arm 13 of the arm member 11 that transits to the closed configuration.
  • the state in which the pair of protrusions 204 are engaged with the proximal recess 208B in the inner cavity 205 of the slider 202 is maintained.
  • the pair of protrusions 16 and 17 are pulled back to the position projecting from the opening on the proximal end side of the pressing tube 31 to abut and engage with the proximal end surface of the pressing tube 31. .. That is, even if the operator releases the force for moving the arm member 11 to the proximal end side of the pressing tube 31, the pair of protrusions 16 and 17 is locked to the distal end side with respect to the proximal end surface of the pressing tube 31. The stopped state is maintained. The arm member 11 is restricted from moving toward the distal end side with respect to the pressing tube 31, and the state of holding the target tissue T in the closed form is locked.
  • the hook portion 3c hooked on the intermediate portion 14 of the arm member 11 is located closer to the base end side than the base end side opening of the pressing tube 31, and is housed in the sheath 66. Further, in this state, since the pair of protrusions 16 and 17 of the arm member 11 are locked to the distal end side with respect to the proximal end surface of the pressing tube 31, the pressing tube 31 contacts the sheath 66 but does not press each other. become. The operator can move the integrated arm member 11 and pressing tube 31 together with the operation wire 62 by operating the slider 202.
  • the operator When the target tissue T is tightly bound by the first arm 12 and the second arm 13 of the arm member 11 in the closed configuration, the operator further pulls the slider 202 back to the proximal end side.
  • the amount of tensile force in the small diameter portion 3b provided in the connecting member 3 becomes equal to or larger than the predetermined tensile strength of the small diameter portion 3b, the small diameter portion 3b of the connecting member 3 breaks. .
  • the state in which the target tissue T is grasped by the arm member 11 is maintained, and the arm member 11, the pressing tube 31, and a part of the connecting member 3 are integrated and left in the body.
  • the clip 10 ligating the target tissue T is left in the body.
  • the operator operates the endoscope, takes out the medical device 2 from the channel of the endoscope, performs the necessary treatment, and ends the series of procedures.
  • the same operation as in the above-described first embodiment can be considered. Specifically, the operator first pushes the slider 202 in the slit 201b to a most advanced position, that is, a position where the slider 202 comes into contact with the tip surface 201a of the slit 201b. Then, the operator holds the knob 206 of the wire adjusting member 203 without operating the slider 202, and slides the main body 207 toward the distal end side along the direction of the axis C1.
  • the operator does not operate the slider 202 but operates only the wire adjusting member 203 to move the connecting portion between the operation wire 62 and the hook 62a to a position protruding from the opening on the distal end side of the sheath 66. ..
  • the clip 10 can be reloaded and the target tissue T can be re-grasped using the clip 10. Both can be achieved.

Abstract

Selon l'invention, un instrument médical est équipé : d'une unité pince possédant un premier bras, un second bras et une première articulation ; et d'un applicateur possédant un câble de manipulation. Ledit applicateur est équipé : d'une seconde articulation agencée sur le câble de manipulation ; d'une gaine ; d'une première partie manipulation déplaçant ladite seconde articulation sous l'effet de mouvements d'avance et retrait ; et d'une seconde partie manipulation régulant la distance de ladite première partie manipulation à ladite seconde articulation. Lorsque ladite seconde articulation est positionnée à l'intérieur de ladite gaine, la transition entre un état de mise en prise et un état de désengagement de ladite seconde articulation, est commandée par ladite gaine. Lorsque ladite seconde articulation dépasse de ladite gaine, la transition dudit état de désengagement vers ledit état de mise en prise est possible. Ladite seconde partie manipulation peut modifier ladite distance de ladite première partie manipulation à ladite seconde articulation, de première distance en seconde distance, sous l'effet de mouvements différents desdits mouvements d'avance et retrait de ladite première partie manipulation.
PCT/JP2018/046121 2018-12-14 2018-12-14 Applicateur, et instrument médical ainsi que procédé d'installation de celui-ci WO2020121519A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
CN201880100067.9A CN113164174A (zh) 2018-12-14 2018-12-14 供给器、医疗设备以及医疗设备的安装方法
PCT/JP2018/046121 WO2020121519A1 (fr) 2018-12-14 2018-12-14 Applicateur, et instrument médical ainsi que procédé d'installation de celui-ci
US17/344,072 US20210298759A1 (en) 2018-12-14 2021-06-10 Applicator, medical apparatus, and operation method of medical apparatus

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2018/046121 WO2020121519A1 (fr) 2018-12-14 2018-12-14 Applicateur, et instrument médical ainsi que procédé d'installation de celui-ci

Related Child Applications (1)

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US17/344,072 Continuation US20210298759A1 (en) 2018-12-14 2021-06-10 Applicator, medical apparatus, and operation method of medical apparatus

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WO2020121519A1 true WO2020121519A1 (fr) 2020-06-18

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11567237B2 (en) 2018-08-17 2023-01-31 Corning Incorporated Inorganic oxide articles with thin, durable anti-reflective structures

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH11332870A (ja) * 1998-05-28 1999-12-07 Asahi Optical Co Ltd 内視鏡用処置具の操作部
JP2006158668A (ja) * 2004-12-07 2006-06-22 Olympus Corp 内視鏡用処置装置
JP2007244826A (ja) * 2006-03-16 2007-09-27 River Seiko:Kk 内視鏡用処置具
JP2010081970A (ja) * 2008-09-29 2010-04-15 Fujifilm Corp 連発式クリップ処置具
JP2015149997A (ja) * 2014-02-10 2015-08-24 住友ベークライト株式会社 内視鏡用クリップ装置、内視鏡用クリップ装置キットおよびクリップ
WO2018011846A1 (fr) * 2016-07-11 2018-01-18 オリンパス株式会社 Instrument de traitement endoscopique

Family Cites Families (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7494461B2 (en) * 2003-09-30 2009-02-24 Boston Scientific Scimed, Inc. Through the scope tension member release clip
JP2006068076A (ja) * 2004-08-31 2006-03-16 Olympus Corp 内視鏡用処置具
EP1818020B1 (fr) * 2004-12-07 2017-05-10 Olympus Corporation System de produits d'endo-thérapie et cartouche comprenant un instrument de traîtement
JP2009195451A (ja) * 2008-02-21 2009-09-03 Terumo Corp 操作機構及び該操作機構を備える医療用器具
JP2010029448A (ja) * 2008-07-29 2010-02-12 Fujifilm Corp 連発式クリップ処置具用操作ハンドルおよびそれを用いる連発式クリップ処置具
JP5781347B2 (ja) * 2011-03-28 2015-09-24 日本ゼオン株式会社 内視鏡用処置具
JP5427857B2 (ja) * 2011-09-15 2014-02-26 富士フイルム株式会社 クリップユニット及びこれを用いた結紮装置、並びにクリップユニットの製造方法
JP5963702B2 (ja) * 2013-03-29 2016-08-03 日本ライフライン株式会社 医療機器
JP5750620B2 (ja) * 2013-05-07 2015-07-22 オリンパス株式会社 内視鏡処置具
JP6233147B2 (ja) * 2014-03-31 2017-11-22 日本ゼオン株式会社 留置スネア用結紮装置
AU2015273803B2 (en) * 2014-06-10 2019-06-13 Bibbinstruments Ab Endoscopic biopsy instrument

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH11332870A (ja) * 1998-05-28 1999-12-07 Asahi Optical Co Ltd 内視鏡用処置具の操作部
JP2006158668A (ja) * 2004-12-07 2006-06-22 Olympus Corp 内視鏡用処置装置
JP2007244826A (ja) * 2006-03-16 2007-09-27 River Seiko:Kk 内視鏡用処置具
JP2010081970A (ja) * 2008-09-29 2010-04-15 Fujifilm Corp 連発式クリップ処置具
JP2015149997A (ja) * 2014-02-10 2015-08-24 住友ベークライト株式会社 内視鏡用クリップ装置、内視鏡用クリップ装置キットおよびクリップ
WO2018011846A1 (fr) * 2016-07-11 2018-01-18 オリンパス株式会社 Instrument de traitement endoscopique

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11567237B2 (en) 2018-08-17 2023-01-31 Corning Incorporated Inorganic oxide articles with thin, durable anti-reflective structures

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